Individual
DR. GAIL HEGEMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH D
Contact information
Practice address
1711 COUNTY ROAD B WEST, SUITE 144S, ROSEVILLE, MN 55113-4100
(651) 635-0909
(612) 822-8669
Mailing address
1711 COUNTY ROAD B WEST, SUITE 144S, ROSEVILLE, MN 55113-4100
(651) 635-0909
(612) 822-8669
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
LP2464
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
30269000
MAGELLAN BEHAVIOR HEALTH
—
01
—
59123AR
BCBS
MN
01
—
59125HE
BCBS
MN
01
—
6113193
UNITED BEHAVIORAL HEALTH
MN
05
—
642047800
—
MN
Enumeration date
08/25/2005
Last updated
03/13/2024
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